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HomeMy WebLinkAboutMortgage_Walker'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year � FOR DEDUCTION FROM ASSESSED VALUATION � Siate Fortn a3709 (R77 / 6-09) '� � Prnsmbed by DepaNneM allaml Govemmem France � INSTRUCTIONS: To 6e filed in person a by mail with [he CountyAuditor or Counry Recorder of the county whe�e Ihe property is located. Fifing Dates: i) Real Property: Must file dunng fhe year for which the tleduction is soughf. 2) Mobile / Manufactured Homes not assessed as Real Property: Must file dunng the twelve (12) months 6efo�e Maroh 31 of each year the deduction is sought. See reverse side fnr addilional instruclions arM qualrficatbns. MP�D� (ownerorcontrdtt Duyer- see rystri�ryoru m ryyer;Qsile) AsessW�a(dedreal ad Ma�di 1, aifmt year If ro, what a his ! her erart stiare ol interest? Counry Autlitor iEer/IegaldesaipUOn Recordfwmber PaBenumbu -�0-.3�-yoo-ooi. y5.3-o a/ �--009 47�1� MortgaBe / Cantraa'ude6tedfmss unpaid as of Mwigage / Contrad'udebtedness unpaid az o( Is Ne aOP��t Ne sole MarM t, wnent tlate of appfication legal w eWibde avmeR � � /j Q (� ❑ Yes ❑ No If name on remrd is Eitferent ihan Nat o( app0onl, indicate 6elow. f•T••'1Ti or oNer owner or hdder ot mortga5e Adtlress ot asUgnce (numbar aM sbee; tlry, stafi, antl ZIP catle) Does epplinnt own propeny in anY other I Ii yes. munrymindiana? � __ � _. 20 20 na dCqwryAUditOr I/ We ceNry und r the penal owner l�contracl buyer of Ne If wmed with someone aher ihan ,aMLPcode) � COUNTYAUDROR 20 20 20 Counry sGOn: Mnually Assessed � NmuaRyAssessed Mobile Fiome (IC 61. ' V�^i`��...... prawcr \0 ............. Card NO. ... �� y � ...... a�-� �,q95,� 20 �ate imonN. 20 that the above and foregoing infortnation is We and correcl arW fhat the applinnt is a resident of Indiana and ned property on date apP���tion is filed. v/ Date (mmfi. daY• i'aa� tiry, sfate, arM Gy EWy esecuted Power olAlf�mey or by IC 61.1-12-0.7 Add2ss of a Wwmed person �num0er arM sbeef, tity, stare, Date (rmnN. dfi: l'�/)